Lamotrigine is an anticonvulsant drug used to treat partial and generalized seizure disorders. Hypersensitivity to lamotrigine usually causes mild symptoms such as fever, rash, and slight invasion of internal organs. However, a 33-year-old male patient who was admitted with Stevens-Johnson syndrome after taking lamotrigine for 15 days experienced hepatic failure and died 5 days after admission. This case demonstrates the importance of realizing that lamotrigine can lead to fatal hepatic failure, and that tests for the normal liver function should be performed when administering lamotrigine.
Adult ; Alanine Transaminase/blood ; Anticonvulsants/*adverse effects/therapeutic use ; Aspartate Aminotransferases/blood ; Drug Hypersensitivity/complications/*diagnosis ; Humans ; Liver/enzymology/metabolism ; Liver Failure/*etiology ; Male ; Stevens-Johnson Syndrome/diagnosis/drug therapy ; Triazines/*adverse effects/therapeutic use

We report a case of bronchiolitis obliterans associated with Stevens-Johnson syndrome. A 59-year-old man presented with respiratory distress that gradually worsened over 3 months. He had been diagnosed with Stevens-Johnson syndrome 3 months before admission. He had no history of previous airway disease. On physical examination, expiratory breathing sounds were not audible, and a chest X-ray revealed a hyperinflated lung. A pulmonary function test indicated a severe obstructive pattern. Computed tomography scans of inspiratory and expiratory phases of respiration showed oligemia and air trapping, and both were more prominent on expiration view than on inspiration view. The pathogenesis of bronchiolitis obliterans associated with Stevens-Johnson syndrome is largely unknown.
Anti-Bacterial Agents/therapeutic use ; Bronchiolitis Obliterans/etiology/*radiography/therapy ; Bronchoscopy ; Dyspnea/*complications ; Fatal Outcome ; Humans ; Male ; Middle Aged ; Radiography, Thoracic ; Respiratory Distress Syndrome, Adult/*etiology/therapy ; Respiratory Function Tests ; Roxithromycin/therapeutic use ; Stevens-Johnson Syndrome/*complications/drug therapy ; Tomography, X-Ray Computed/methods ; Tracheostomy